Efficacy and Safety of Shexiang Baoxin Pill for Coronary Heart Disease after Percutaneous Coronary Intervention: A Systematic Review and Meta-analysis

Abstract

Objective. Shexiang Baoxin Pill (SBP) is a licensed Chinese herbal pharmaceutical that has been widely accustomed to treat coronary heart disease (CHD) after percutaneous coronary intervention (PCI). This study points to systematically assess the efficacy and security of the combination of SBP with conventional western medicine in the treatment of CHD after PCI. Methods. Databases including PubMed, the Cochrane Library, Web of Science, Embase, CNKI, Wanfang, VIP, and SINOMED were searched to collect RCTs on SBP in CHD after PCI before July 2021. Review Manager 5.3 was used to analyze the data. The Cochrane Collaboration Bias Risk Tool is used to assess the quality of methods. Results. A total of 19 eligible trials of 2022 patients with CHD after PCI were finally included. The results of the aggregate evidence showed that, compared with routine western medicine treatment alone, the combination of SBP with conventional treatment trial groups could significantly reduce the incidence of major adverse cardiac events (MACE) of the patients (RR = 0.38, 95% CI (0.29, 0.51), P < 0.00001 ). SBP also significantly enhanced left ventricular ejection fraction (LVEF) (MD = 4.00, 95% CI (3.42, 4.58), P < 0.00001 ) and lessened N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) levels (MD = −167.18, 95% CI (−174.80, −159.57), P < 0.00001 ). In addition, the inflammatory mediators and blood lipid index in the experimental group after the combined therapy were also mediated ( P < 0.05 ). Moreover, SBP did not increase the incidence of adverse reactions during treatment. The results of subgroup analysis illustrated that the length of the intervention course might be the source of the heterogeneity of NT-pro-BNP and hs-CRP. Conclusion. SBP could demonstrate a beneficial role in patients with CHD after PCI of reducing the incidence of MACE and improving LVEF, NT-pro-BNP, inflammatory mediators, and blood lipid index. However, limited by the quantity and quality of eligible studies, the above conclusions required more standardized, rigorous, high-quality clinical trials to verify further.

Single-nucleus ribonucleic acid-sequencing and spatial transcriptomics reveal the cardioprotection of Shexiang Baoxin Pill (SBP) in mice with myocardial ischemia-reperfusion injury

“…The underlying rationale for this phenomenon could be ascribed to the suboptimal sensitivity of TTC staining in infarction size detecting ( Ito et al, 1997 ). Some clinical studies ( Qin et al, 2021 ; Wei et al, 2021 ) have found that SBP increased LVEF and decreases BNP levels. However, our study results were not entirely consistent with this finding.…”

Cost-effectiveness analysis of Shexiang Baoxin Pill (MUSKARDIA) as the add-on treatment to standard therapy for stable coronary artery disease in China

“…Prior evidence indicates that SBP has a therapeutic effect on all types of chronic coronary syndromes (CCS) and acute coronary syndromes (ACS) [22], and long-term application can improve the symptoms of patients with coronary heart disease and reduce cardiovascular events [14,28]. The findings were reported by a systematic review and meta-analysis of 19 eligible trials concluding that the combination of SBP with conventional treatment trial groups could significantly reduce the incidence of MACE, enhance left ventricular ejection fraction (LVEF), and lessen N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) levels [29]. Similarly, the results from a systematic review and network meta-analysis of 179 eligible trials suggested that SBP combined with Western medicine is presumably the optimal treatment prescription for both clinically effective and cardiovascular event rates [30].…”

Metabolic dysfunction-associated fatty liver disease and cardiovascular disease: A meta-analysis

“…CVD was still one of the leading causes of morbidity and mortality worldwide, accounting for approximately 31.5% of deaths worldwide and 45% of deaths from noncommunicable diseases (16)(17)(18). CVD shared many risk factors with MAFLD, including diabetes, abnormal lipid metabolism, hypertension, insulin resistance, and inflammation (9,19).…”